Provider Demographics
NPI:1952488512
Name:LIMB, ANDREW JUNGWOOK (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JUNGWOOK
Last Name:LIMB
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1111 EXPOSITION BLVD BLDG 700
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4314
Mailing Address - Country:US
Mailing Address - Phone:916-736-3399
Mailing Address - Fax:916-233-4171
Practice Address - Street 1:10200 TRINITY PKWY STE 201
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-7288
Practice Address - Country:US
Practice Address - Phone:209-952-0483
Practice Address - Fax:209-478-5785
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-05-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA71527207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA119935Medicare PIN
CAH22489Medicare UPIN